title: Effect of Shenfu on inflammatory cytokine release and brain edema after prolonged cardiac arrest in the swine.
abstract: OBJECTIVE
  Shenfu injection (SFI), a traditional Chinese formulation, has been confirmed to be protective against brain during ischemia and reperfusion injury. In this exploratory study, we investigated the action of SFI in regulating the inflammatory response and brain edema after cardiopulmonary resuscitation.
  
  
  METHODS
  After 8 minutes of untreated ventricular fibrillation (VF), pigs in the cardiopulmonary resuscitation group (n = 24) received a central venous injection of either SFI (SFI group; 1.0 mL/kg), epinephrine (EP group; 0.02 mg/kg), or saline (SA group). Levels of porcine-specific tumor necrosis factor α and interleukin in sera were measured using enzyme-linked immunosorbent assay at 0.5, 1, 2, 4, 6, and 24 hours after return of spontaneous circulation (ROSC). Surviving pigs were killed 24 hours after ROSC, and the brains were removed for electron microscopy, Western blotting, and quantitative real-time polymerase chain reaction analysis.
  
  
  RESULTS
  Compared with the EP and SA groups, SFI decreased the levels of tumor necrosis factor α and interleukin-6 in serum and the brain (P < .05) and decreased the expression of nuclear factor κB and aquaporin-4 messenger RNA in the brain (P < .05). Shenfu injection also inhibited the expression of nuclear factor κB, matrix metalloproteinase 9, and aquaporin-4 protein after ROSC (P < .05). Observation of brain tissue ultrastructure showed that injury was alleviated in the SFI group compared with the SA and EP groups.
  
  
  CONCLUSIONS
  Our exploratory experiments demonstrated that SFI reduced cerebral damage in a porcine model of VF, which may be related to suppression of the inflammatory reaction and decreased brain edema after ROSC.
authors.affiliation: Emergency Department of Beijing Chaoyang Hospital, Capital Medical University, Chaoyang District, Beijing, China.
authors.forename: Xiaomin
authors.initials: X
authors.lastname: Hou
authors.forename: Chunsheng
authors.initials: C
authors.lastname: Li
authors.forename: Wei
authors.initials: W
authors.lastname: Gu
authors.forename: Zhijun
authors.initials: Z
authors.lastname: Guo
authors.forename: Wenpeng
authors.initials: W
authors.lastname: Yin
authors.forename: Da
authors.initials: D
authors.lastname: Zhang
mesh_terms: D000818:Animals; D051401:Aquaporin 4 / Q000032:analysis / Q000097:blood; D001923:Brain Chemistry / Q000187:drug effects; D001929:Brain Edema / Q000209:etiology / Q000517:prevention & control*; D016207:Cytokines / Q000032:analysis / Q000097:blood*; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D006323:Heart Arrest / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D007275:Injections, Intravenous; D015850:Interleukin-6 / Q000032:analysis / Q000097:blood; D007378:Interleukins / Q000032:analysis / Q000097:blood; D020780:Matrix Metalloproteinase 9 / Q000032:analysis / Q000097:blood; D016328:NF-kappa B / Q000032:analysis / Q000097:blood; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D060888:Real-Time Polymerase Chain Reaction; D013552:Swine; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis / Q000097:blood
chemical_list: D051401:Aquaporin 4; D016207:Cytokines; D004365:Drugs, Chinese Herbal; D015850:Interleukin-6; D007378:Interleukins; D016328:NF-kappa B; D018696:Neuroprotective Agents; C492793:Shen-Fu; D014409:Tumor Necrosis Factor-alpha; D020780:Matrix Metalloproteinase 9